Thursday, August 21, 2008

How Safe Are Psychiatric Drugs?

In my last post, The Geography Of Mental Illness, I wondered whether genes play as strong a role in mental illness as pharmaceutical companies would have us believe. I mean, how did so many mental illness genes end up in Utah?

I wouldn't argue against the idea that a "chemical imbalance" is at the root of conditions that drugs are being prescribed to treat, conditions such as depression, anxiety, stress-related disorders, phobias, social anxiety disorder. I don't know. However, I would argue against the idea that drugs are the most effective treatment for most people. They certainly aren't the only treatment. Unfortunately, they're the first-line treatment in this country.

We don't even understand fully how these drugs work, or how safe they are, yet millions of Americans are taking them, billions of dollars are being pocketed by the sale of them.

Take one class of antidepressants, the Selective Serotonin Reuptake Inhibitors (SSRIs):

"While serotonin has something to do with depression, the relationship is not a simple nor a well-understood one. ... While the SSRIs do indeed act on serotonin regulation in the brain, allowing the neurotransmitter to linger a little longer in the synapses, the changes that the drug ultimately exerts on the brain are entirely unclear. As an indicator of how little we know, it is striking that one of the more popular antidepressants in Europe, tianeptine, is a serotonin reuptake enhancer - it has the opposite effect of the SSRIs, allowing less serotonin to flow between the synapses."- Charles Barber, Comfortably Numb: How Psychiatry Is Medicating a Nation

In an earlier post, I noted that the dependence and withdrawal problems associated with SSRIs are only now coming into mainstream discussion; that their addictive qualities may in fact, as David Healy put it, be greater than "any psychotropic drug ever."

Update: See my next post for an alternative (or adjunct) to psychiatric drugs.